1. Field of the Invention
The present invention relates to systems and methods for handling data, and in particular, to techniques and equipment for dealing with advance directives.
2. Description of Related Art
An advance directive is a type of written or verbal instruction about health care to be provided if a person becomes unable to make decisions regarding his or her medical treatment. As used herein the term advance directives shall include, but not be limited to, health care proxies, living wills, a do not resuscitate (DNR) instruction, or information/instructions about organ donation.
Increased awareness of the importance of advance directives has prompted various laws encouraging their use. Under the Federal Patient Self-Determination Act of 1991, hospitals are required to ask patients about advance directives and assist them if they wish to prepare an advance directive. In some jurisdictions, state law will require the custodian of an advance directive or the possessor of information about an advance directive to release information about the advance directive in response to proper requests for this information.
U.S. Living Will Registry of Westfield, N.J. operates a database where digital images of advance directives are centrally stored. In the traditional scheme, individuals that registered and stored their advance directives on this database have agreed in writting that the stored information will be made available to a wide class of service providers, such as hospitals, physicians, etc. Health care providers that are privileged subscribers to this registry have been able to automatically access database documents that were previously and independently registered by patients. Subscribers have obtained documents by using a secure Internet web site employing encrypted transmission, or by using automated telephone systems that send documents to registered facsimile machines. Non-subscriber health care providers have been able to obtain documents from the registry by calling and requesting the documents.
Traditionally, this registry placed all authority in the person executing the advance directive by virtue of a registration contract signed by the person. This approach did not take into account the fact that service providers such as hospitals often gain custody of these instruments without the benefit of a registration contract. Nevertheless, these service providers need to take appropriate steps to store and organize these instruments and, when appropriate, make them available on short notice, often during emergencies. The difficulty of this task is compounded when the service provider is part of a network of hospitals that want to deal with these advance directives cooperatively.
Referring to reference mostly filed after the commencement of the above noted operations by U.S. Living Will Registry, in U.S. Patent Application Publication No. U.S. 2003/0040939 a person can complete an advance directive and send it to a facility that will scan the document and store it in a database. Using a password, authorized users can access this information either over a telephone network or over the Internet. The information can be retrieved either by facsimile or by printing a document obtained over the Internet.
In International Publication No. WO 01/06436 advance directives can be scanned and stored in a central database for access by authorized individuals. A user can designate in advance a list of key institutions that will have access to this information. The system has “expert” features that check whether the stored directives comply with a relevant jurisdiction. See also U.S. Pat. No. 5,241,466.
In International Publication No. WO 02/37235 a participant is provided information and asked a number of questions regarding life planning issues, including questions about living wills. After all the information is supplied, information is stored in a database and can also be sent to a designated person. Information in this database can be accessed by “the client, the assigned caregiver(s)/person(s) listed in charge of future arrangements, the assigned attorney, the coroners office, and/or emergency medical personnel.” Initiation, access, and continuation of the centralized data storage is controlled by the participant, although third party updates can be authorized.
In International Publication No. WO 01/99027 emergency personnel can identify a patient by scanning the iris of, or a transporter worn by, a patient. This identifying information is sent wirelessly over the Internet to a database that stores advance directives that are then retrieved and displayed to the emergency personnel.
In U.S. Patent Application Publication No. U.S. 2002/0196141 patient information can be stored on databases maintained by individual hospitals or on a central server. A system administrator can establish which subscribers have access and the level of access. Subscribers such as doctors, hospital personnel, insurance companies, etc. gain access to the database by using either a password or by presenting for scanning a token with a bar-code.
In U.S. Patent Application Publication No. U.S. 2002/0169638 a database of medical records can be accessed by a medical entity. The reference describes connecting to a database server through wireless devices having a range of 20 miles or more so that “medical facilities and providers can link together, thus sharing patient data and allowing for continuous access to the patient electronic record.” Paragraph 14.
U.S. Patent Application Publication No. U.S. 2001/0034617 describes a system where hospitals or other cooperating companies can be authorized by a patient to gain access to medical records stored in a database. The hospitals and the patient must both register with this service.
In U.S. Patent Application Publication No. U.S. 2002/0029264 a hospital or other subscriber can send raw MRI image data for processing by a central server. The processed information can be sent back to a number of different hospitals designated by the originating hospital.
In U.S. Patent Application Publication No. U.S. 2002/0188467 patients, health-care providers, insurance companies, and pharmacies can gain access to patient information stored on a central server. Unauthorized access to the server is prevented by (1) employing hardwired business to business connections; (2) encrypting information sent over the Internet; (3) passwords; (4) compartmentalizing information by allowing a user access to only those portions of a patient's medical records that are necessary for the issue at hand; and (5) providing information on a CD-ROM.
In U.S. Patent Application Publication No. U.S. 2002/0103675 patient information may be stored by patient or by hospital and stored in a central database. Users such as patients, physicians, hospitals, pharmacies, etc. can gain access to the patient information.
In U.S. Patent Application Publication No. U.S. 2001/041991 medical records can be accessed over the Internet by a patient or by individuals authorized by the patient.
The description herein of some references having a publication or issuance date less than one year from the effective filing date of the present application, does not imply the reference is prior art, but is included simply to enhance the scope of applicant's disclosure. In this regard, see U.S. Patent Application Publication No. U.S. 2003/120527 (access to patient information over the Internet granted depending on the individuals' need for information); U.S. Patent Application Publication No. U.S. 2003/0101081 (surgeons individually or as a group can subscribe to a service that stores postoperative notes that are made available to them, hospitals, patients, anesthesiologists, etc.); U.S. Pat. No. 6,157,914 (a hospital can download centralized medical information from a different hospital, switching to different systems in order to gain access); U.S. Pat. No. 6,604,115 (cardiovascular data stored in a database is made available over a network either intrahospital or interhospital); and U.S. Pat. No. 6,574,742 (hospitals can outsource their picture archiving and communications systems (PACS) requirement by communicating over a network to a central database).